Children's Hospital could get as much as $20 million from the city of Birmingham toward its planned $450 million expansion through a development proposal announced by Birmingham Mayor Larry Langford. The hospital wants to build a facility just north of its current location that would house most of its 275 licensed beds, a much larger emergency department, operating rooms and other services. Children's also plans to ask the state for more licensed beds as part of the Certificate of Need application the hospital will file with state health regulators in the next few months.
The death of an American Airlines passenger during a flight from Haiti to New York in February has cast a spotlight on the growing number of medical emergencies on commercial jets, a trend that largely has escaped public notice because airlines aren't required to report such incidents. A report by MedAire, an Arizona-based company that provides emergency medical advice to airlines, indicates the rate of medical emergencies aboard commercial flights nearly doubled from 2000 to 2006, from 19 to 35 per 1 million passengers.
The current decade hasn't been kind to Maryland's babies, with rising percentages born underweight or dying in infancy, according to a report by Advocates for Children & Youth. Meanwhile, declining percentages of women were entering prenatal care early in their pregnancies, according to the most recent data, depriving them of care needed to stave off bad outcomes.
Executives of a failed healthcare company turned a good business into "a pack of lies" as part of a scheme that defrauded investors of $1.9 billion, a federal prosecutor said during closing statements in a month-old white-collar crime trial. Two former owners and three former executives of National Century Financial Enterprises broke promises, misled investors and tried to cover up wrongdoing, Assistant U.S. Attorney Wes Porter said in U.S. District Court.
Continued flat funding of the National Institutes of Health threatens a generation of researchers and the fate of American healthcare, warned officials from a prominent teaching hospital and six research institutions that included Ohio State University. The group issued a report, "A Broken Pipeline? Flat Funding of the NIH Puts a Generation of Science at Risk," which chronicles the struggle of a dozen junior researchers had securing funding for medical research.
A new study shows that most Internet users ages 45 and older believe online content, Web site design and online advertising are skewed toward a younger audience. Web users ages 18 to 24 and 25 to 34, by contrast, are most likely to say online content is focused on people their age. More than half of those 35 to 44 find online content geared to their age group, the study found.
Despite all the buzz around user-generated content and visitors to social networking sites, consumers actually spend a relatively small share (only 7.5%) of their time online with community sites, according to the Online Publishers Association's Internet Activity Index. The latest index results break online destinations into five categories: search, content, commerce, communication and community. Of these sites, 42.7% of consumer time online is spent with content sites, 28.6% is with communication sites, 16.1% with commerce sites and 5 percent on search sites.
A new analysis of online consumer data shows that large Web companies are learning more about people than ever from what they search for and do on the Internet. These companies gather clues about the tastes and preferences of a typical user several hundred times a month, and use that information to predict what content and advertisements people most likely want to see.
Every week, it seems, I read a different prediction about consumer-driven healthcare. It's already here. It'll be here any minute now. It's on the horizon. It's on the distant horizon. It's a passing fad. It's a bunch of hooey. The truth, I suspect, lies somewhere in between "already here" and "hooey."
I can't help but look at the issue as a consumer--one who takes the time to research providers and medical conditions online, who is willing to pay more for better quality care, who isn't afraid to fire a provider if he or she doesn't meet my expectations and who will tell everyone within earshot about negative or positive experiences at the local hospital, including my primary care physician. But I'm just one person. And for some strange reason the pundits aren't basing their predictions solely on me.
One of the latest predictions about the consumer revolution comes from Don Seymour, president of Don Seymour and Associates in Winchester, MA. "The transition to consumer-driven healthcare will be evolutionary, not revolutionary, and cost, not quality, has been the driver to date," he writes in the introduction to Futurescan 2008, an annual report from the Society for Healthcare Strategy and Market Development (SHSMD) on a wide range of healthcare trends and their implications for strategic marketers, planners, and senior leaders.
If you look at more than a decade of these reports, Seymour writes, there is a clear, overarching message to the nation's hospitals: "Take care of more people who have growing expectations and more complex medical needs while providing increasingly sophisticated care with relatively fewer resources."
But, he adds, "lest consumerism become to the 2000s what capitation was to the 1990s--overhyped and precipitously reacted to--Futurescan readers are advised to proceed with a dose of caution." Among the data he points to: Out-of-pocket costs are relatively low, employer interest in consumer-driven products remains low, and decision-support for consumers is limited.
"Although the Internet is an important source of health information, barriers to its use include a lack of standardized performance measures, a lack of comprehensive information, and inconsistent information," he writes.
And that's where he loses me.
I get that consumerism isn't here yet, that it might not even be here any minute now. I get that health savings accounts aren't as ubiquitous as 401(K) plans. I get that not everybody's like me. But I don't think that the lack of standardized information online is going to stop people from making a decision about whether or not they want to go to your hospital, use your physicians and specialists, or tell everyone they know about their experience there.
In fact, all the lack of standardized information means is that people are going to make decisions based on whatever they can dig up online--be it nasty blog posts from a disgruntled employee, the story in the local paper about traffic hassles caused by the construction of your new building, or the fact that your competition is printing price and quality information on its own site, even if that information is oversimplified or misleading.
One of the six "magatrends" cited in the Futurescan report, in addition to consumerism, is competition. It seems to me that increased competition would be more of a minitrend if consumerism wasn't at play. Consumers who care about reputation and word-of-mouth might question a referral from their primary care physician. Patients who care about price might consider medical tourism, while patients who care about quality would think twice about getting surgery in a country where they can't drink the water.
OK, there's the issue of margaritas and sandy beaches. But that's a kind of consumer experience, too.
I respect the thought leaders who work hard to sift through data and reports, talk to industry insiders, and tap their own deep understanding of the healthcare market to create the annual Futurescan report. I wonder, though, what future reports will say about consumerism. Will the consumer revolution ever begin in earnest? Or will it turn out to be a bunch of hooey?
The three candidates who remain in the race for the White House have presented healthcare plans that include mandates, quality measures, and tax credits, but there is another option that more than 10 states have implemented, which could help reduce costs while removing barriers to care for the 47 million uninsured Americans.
The idea is mandate-lite legislation, which allows health insurers to offer plans that are not as mandate-heavy. It is quite a departure from the mandated health insurance movement.
Mandated health insurance is a relatively new phenomenon. Over the past 40 years, well-meaning leaders have implemented mandates that they believe will improve care, but these mandates have resulted in increased healthcare costs.
It's interesting that the trend toward mandates mirrors government's added influence over individuals' lives. Combine a growing number of Americans' support of greater governmental influence with the fact that many see themselves as non-stakeholders in their own healthcare, and you have a big brother system that mandates services and frowns upon choice.
According to the Council for Affordable Health Insurance, a research and advocacy association of insurance carriers, in its "Health Insurance Mandates in the States 2008," there are 1,961 mandated healthcare benefits and providers throughout the country. Those mandates are increasing healthcare costs (in some states, more than 50%), according to the study.
Some of the state mandates are:
Hair and limb prostheses, bone mass measurement, and care for TMJ disorders
Providers like dentists, optometrists, and marriage therapists
Covered persons such as non-custodial children, dependent students (some as old as 30), and adopted children
Then there are the states that mandate services like athletic trainers (Arkansas), and cover persons like legal non-residents living in the U.S. (Maine). The vast majority of mandates barely increase costs on their own, but when hundreds of mandates are piled on top of one another, costs rise resulting in lower-middle-class Americans being priced out.
There is good news though. There has been state legislation to loosen those healthcare mandates and require a mandate's economic impact be considered when a bill is presented. Mandate-lite gives smaller businesses a chance to offer health insurance that isn't weighed down by the requirements that many health plans have, allowing companies to offer lower-cost options to such under-covered groups as recent college graduates. Health plans with fewer mandates allow the 20s-set to purchase basic health insurance without being forced to pay fees for coverage they will probably not use, such as chronic disease, grandchildren, or cleft palate coverage.
Some states have found mandate-lite legislation as a way to cut healthcare costs, but the idea isn't part of the president hopefuls' healthcare plans. Instead, there is talk of more mandates, tax credits, and retail clinics.
